The authors have treated three cases of serious complications of chronic suppurative otitis media at the Pusan National University Hospital during the past year. The first was a 23 year old Korean male having left peripheral facial nerve paralysis and acute meningitis due to chronic suppurative otitis meia and mastoiditis. The second was a 23 year old Korean male having acute meningitis and a left temporal lobe abscess due to left chronic suppurative otitis media and mastoiditis. The third was a 19 year old Korean male having acute meningitis due to right chronic suppurative otitis media and mastoiditis. All of these were treated by mastoid surgery for the elimination of the focus of infection, antibiotics determinded by sensitivity test, and spinal tap. The first was discharged 8 wks after admission, with subsidence of all symptoms and signs except the permanent facial paralysis. The second died on the 9th postoperative day. The third died during an episode of vomiting on the 6th post-operative day. The authors reviewed the literature and found a relatively high mortality rate in patients with serious complications of otitis media occurring prior to as well as after the use of antibiotics. Many lives of patients with serious complications from otitis media have been saved by the use of antibiotics. However, in recent years, we have recognized the increasing complications and deaths from suppurative otitis media. One of the reasons is the irregular use of the antibiotics by physicians and others producing resistant strains of the etiologic bacteria. The second reason is trauma of the temporal region. In spite of the absence of X-Ray evidence of bone fracture, the infection of the middle ear may pass into the cranium through injured blood vessels and nerves. Two of the present discussed patients had a history of trauma of the temporal region 1wk, prior to the acute exacerbation. This was considered the etiologic factor. In regard to treatment, we would like to emphasize that the focus of infection should be eliminated surgically and that sufficient dosage of specific antibiotic be given for sufficient length of time.